Tri chilemmal carcinoma is an uncommon low-grade malignant lesion of the outer hair sheath, originating from a hair follicle cell. The differential diagnosis includes other skin carcinomas. This study aims at reporting a case of trichilemmal carcinoma admitted at the Otorhinolaryngology and Head & Neck Surgical Ambulatory, Universidade Regional de Blumenau. The patient was an 86-year-old woman complaining of a reddish lesion on the left supraclavicular region, with one year of evolution and progressive growth, presenting a hardened vegetative mass with central ulceration, blood secretion and local pain. The tumor size was 75x45 mm, which was removed surgically with free margins. Considering that this type of lesion seldom develops metastases or local recurrences, adjuvant therapy was not adopted. The patient has been periodically followed up.Rev Bras Otorrinolaringol. V.70, n.6, 832-5, nov./dec. 2004